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<br />CONDITIONS OF PERMIT AFFIDAVIT
<br />A. NOTICE OF DEED RESTRICTIONS
<br />'l'be undersigned understands that this pel'lit lilY be subject to 'deed restrictions' wbieb lilY be lOre restrictive than City
<br />regulations. Ibe undersigned asSUles respcmsibility for COIpliance with any applicable deed restrictions.
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<br />B. UNLICENSED CONTRACTORS AND CONTRACTOR RESPONSIBILITIES
<br />If the owner bas bired a contractor or contractors to undertake IOrk, they laY be required to be licensed in accorc1ance with
<br />state and local regulations. If the contractor is not licensed as required by law, both the owner and contractor Iill be
<br />cited for a lisd_anor violation under state law. If the owner or Intended contractor are uncertain as to wbat licensing
<br />reguiruents lily apply for the intendecJ IIOrk, they are advised to contact the City of lepbyrbills Building Departlent, (813)
<br />788-6611. .
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<br />FurtherJlOre, if the owner bas bired a contractor or contractors, be is advised to bave the contractor(s) sign portions of the
<br />'Contractor Sections' of this application for wbieb they .ill be responsible. If you, as the owner sign as the contractor,
<br />you are indicating that you, rather than the contractor, are responsible for the work. If the contractor wiabes you to sign
<br />as contractor that lilY be an indication that be is not properly licensed and is not entitled to peIlitting privileges in the
<br />City of Zepbyrbills.
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<br />C. TRANSPORTATION IMPACT FEES AND UTILITY CONNECTION FEES
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<br />D. CONSTRUCTION LIEN LAW (CHAPTER 713, FLORIDA STATUTES, AS AMENDED)
<br />I certify that I, the applicant, have been provided with a copy of 'Florida's construction Lien LaIr - lkIIeoImer's Protection
<br />Guide' prepared by the Florida Departlent of Agriculture and ConsUIBI Affairs. If the applicant is 8OI8OIl8 other than the
<br />'ownerl, I certify that I bave obtained a copy of the above described docUIent and premse in good faith to deliver it to the
<br />'owner' prior to COII8DCl!l8Dt.
<br />
<br />E. CONTRACTOR'S/OWNER'S AFFIDAVIT
<br />I certify that all the infOIlilUon in this application is accurate and that alllOrk will be clone in CCIIPliance with all
<br />applicable Ins regulating construction, loning, and land developleDt.
<br />
<br />Application is hereby Iilde to obtain a perlit to do,.Iort and installation as indicated. I certify that no wort or
<br />installation baa CDI8IlCed prior to issuance of a perIlt and that all wort will be perfcned to _t standarc1s of all Ins
<br />regulating construction, City codes, loning regulations, and land developElt regulations in the jurisdiction. I also
<br />certify th~t I understand that the regulations of other goverDl8Dtal agencies lilY apply to the"intended worl, and that it is
<br />-r respcmsibility to identify .bat actions I lUSt tate to ~ in COIpliance. Sueb agentles include but are not liaited to:
<br />t Departlent of BnviIODleDtal Regulation - Cypress Baybeads, Wetland Areas and BnviroDleDta1ly Sensitive Lands,
<br />. , . Water ,Wastewater 'l'reatlent
<br />t Soutbwest Florida Water Managl!l8Dt District-Wells, ~JPress Bayllea4s, Wetland Areas, Altering Watercourses
<br />t Any Corps of Ingineers - Seawalls, Docks, lIavigable Waterways
<br />t Departlent of Health & Rehabilitative Services, InvirOJlleDtal Healtb Unit - Wells, Wastewater 'l'reatlent, Septic !ants
<br />t US InvirOJilental Protection Agency -' Asbestosabatl!l8Dt " .
<br />I also certify that, if flU laterial is to be ~ed, inPlood Zone 'I' 'or II,etc.', it is understood that a drainage plan
<br />addressing a 'COI(l8D8iting vol_' will be sublUted wbieb is prepared by a professional engineer registered in the State of
<br />Florida prior to perlit issuance. '.
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<br />A perlit issued shall be cOnstIued to be a license to proceed with the wrt and not as' authority to violate, cancel alter, or
<br />Bet aside any provisions of the ~cbni~lcod~, nor shall issuance of a perlit prevent the Building pfnelal fIOl ,~84fter
<br />requiring a correction of errors in plaos,consUuction, or violations of any code. .vl!lJ perlit'I88uec1 shall ))ecme invalid
<br />unless the wortauthoril8d by sueb perlit. is, ~ced .ithin. sillODtbs 'of issuance, or if IOrt autboriled by, the perllt is
<br />suspended or abandoned for a period of sixlODtbsafter' the tile the IOrt is ~ced. One 90, aiy:e'Jtension of tile, Iill be
<br />allOtled for the perlit with fee charge of t15.00. !be 81tensioD sballhe ,r~ested in lIiting . to ,~ Building Official. An
<br />approved inspection lUSt 'be logged during each Sil,IODtb period; or the project will he consider8c1 abandoned. ., ,
<br />ilARHllIG TO OWRIR: YOUR FAlLURI 'l'O RECORD A t1O'l'ICE OF aIlMIIICBIIDI,MAY RBSUL'l' III YOUR PAYItlG filCE FOR IIIPROVIIIDIS 'l'O YOUR
<br />PROPBR'l'Y. IP YOU IJ'fIIID 'l'O 0Bt11l FIDIICIIIG, COISUL'l' WI'l'H' YOORLDDIR OR IIAnoRIIY BIPORI IIG YOUR .001CE OF
<br />aHlllltlCIIIBIf'l'.JOBS UIDO t2,500 III VALUI DO t101IEID 'l'ORICORD lID POS! I '1I011C1 OF aJtMIIfClllD'l'.
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<br />SIGHA!URI: OIIIIIR OR AGIII!
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<br />
<br />STA'l'I OP FLORIDA
<br />coum OF
<br />The foregoing instrument was acknowledged
<br />before me this , 19____ by
<br />
<br />~O~pFLORIDA kQcs "
<br />The foregoing .1nstl'Ull8llt was acknowledged
<br />before me this \ ~ ';).(0 , 19.95- by
<br />. '~(\'CK'.'\<.Mu~c
<br />who'is personally known to me or who bas
<br />produced .
<br />as identification and wbo did/did not
<br />take ,an oQ.th.
<br />~ ~ o-f:jO---
<br />(Signatur )
<br />
<br />who is personally known to me or who has
<br />produced
<br />as identification and who did/did not
<br />take an oath.
<br />
<br />(Signature)
<br />(Name. Typed, Printed or Stamped)
<br />NOTARY PUBLIC .
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